闭孔疝20例诊治体会

Diagnosis and treatment of 20 cases of obturator hernia

目的探讨闭孔疝的早期诊断及治疗经验。方法对经手术明确诊断的20例闭孔疝的临床资料进行回顾分析，术前行腹部CT检查的12例分为A组，未行腹部CT检查的8例分为B组。结果A组中术前确诊率为91．7％（11／12），B组术前确诊率为25．0％（2／8）；A组无死亡病例，治愈率为100％；B组术后死亡3例，治愈率为62．5％（5／8），病死率为37．5％（3／8）。A组术前确诊率高于B组（P〈0．05），A组病死率低于B组（P〈0．05）。结论提高对闭孔疝的认识，对不明原因的肠梗阻病人尤其是老年体弱女性病人行腹部CT检查有助于闭孔疝早期明确诊断和及时手术，从而减少手术并发症和降低病死率。

Objective To explore the early diagnosis and therapeutic measures of obturator hernia. Methods The clinical data of 20 obturator hernia patients who underwent operation were studied retrospectively. They were divided into two groups（group A： 12 patients having been checked by abdominal CT examination; group B： 8 patients without abdominal CT examination）. Results Rate of preoperative diagnosis in group A and group B was 91.7 % （11/12） and 25.0 % （2/8） respectively. There were no deaths in group A with the curative rate being 100 %. There were 3 deaths after operation in group B with the curative rate being 62. 5 %（5/8）and the mortality rate being 37. 5 %0（3/8）. Rate of preoperative diagnosis in group A was higher than in group B（P〈0. 05）, and mortality in group A was lower than in group B（P〈0. 05）. Conclusion To raise awareness of obturator hernia and perform abdominal CT examination on patients with intestinal obstruction of unknown cause（especially frail elderly female patients）can help early diagnosis of obturator hernia and timely surgery to reduce surgical complications and mortality.